Tackling Health Inequalities with FRAIT

Researchers have developed a practical tool that is helping to reduce long-standing health inequalities for families across Wales.

A health visitor smiles while interacting with a young girl and her father. The child is using a tablet device on the table, with both the health visitor and child engaged in the screen.

For years, Welsh Government policies have aimed to improve outcomes for young children. Health visitors, who support families from pregnancy through the early years, needed a consistent, evidence-based way to identify which families require extra help.

In 2014, USW researchers worked with health visitors across Wales to develop the Family Resilience Assessment Instrument and Tool (FRAIT). Using large-scale consultation and innovative simulation technology, they mapped what ‘family resilience’ really means in practice. The result was a structured assessment, clear guidance, and a training package to support professional judgement and decision-making, focussed on a strengths-based approach to offer support to families where needed.

FRAIT HAS TRANSFORMED HOW WALES SUPPORTS ITS YOUNGEST CITIZENS BY PLACING FAIRNESS AND PREVENTION AT THE HEART OF CARE.

Carolyn Wallace

Professor in Community Health and Care Services

FRAIT was adopted by the Welsh Government as part of the ‘Healthy Child Wales Programme’ in 2016 and became mandatory in 2017. Today, all health visitors in Wales use FRAIT with every family on their caseload (at least 250 families each) across seven key appointments in a child’s early years. This amounts to more than 1.8 million family interactions.

The impact has been significant. Families now receive an evidence-based assessment wherever they live in Wales. Health visitors can identify concerns earlier, tailor support more effectively, and connect families to the right services at the right time. The creation of an all-Wales Health Visitor Community of Practice ensures continuous feedback and improvement, while collaboration with NHS Wales has led to the development of an electronic version, making the assessment even more accessible.